Barking and Dagenham Crisis Prevention

Description

This pre-procurement exercise will allow NELFT to engage directly and collaboratively with potential providers to:<br/>• Aid with procurement process design.<br/>• Determine the level of provider interest.<br/>• Help enable providers to participate in the process.<br/>• Inform development of service specification/s and collaborative service delivery options. <br/>• Help shape the commissioning and contracting process. Lot 1: This specification outlines the development of a Mental Health Crisis Prevention Offer in Barking and Dagenham for a third sector-led service providing non-clinical, community-based mental health support. The service will focus on supporting those experiencing self-defined mental health distress who do not require immediate medical attention. It will offer timely interventions aimed at preventing escalation to statutory services like psychiatric liaison or emergency departments. This initiative aligns with local needs, addressing the unique demographic and socio-economic factors of Barking and Dagenham.<br/><br/>Barking and Dagenham has a population of 214,000, of which only 87% is registered with a GP. 53.9% of the population is from BAME (Black, Asian and Minority Ethnic) communities, including 24% from Black ethnic background and 23% from Asian ethnic backgrounds. It is also the second most deprived of the 32 London boroughs when looking at income levels, as 19.4% of the adult population is income deprived compared to a national average of 12.9% and 83% of LSOAs (Lower Layer Super Output Areas) are in deciles 1-3 of the Indices of Multiple Deprivation. The spread of deprivation in Barking and Dagenham is relatively even, although there are increased rates in around Barking, Dagenham and Becontree. (Joint strategic needs assessment (JSNA) | London Borough of Barking and Dagenham 2022). <br/>Stakeholder engagement commissioned by NELFT in 2023 identified that Barking and Dagenham benefits from 8 existing community hubs split across Barking (4) and Dagenham (4) and has access to the online social prescribing platform Joy Marketplace. There are strong public transport links in and around Barking. Barking and Dagenham does not currently have an Emergency Department (ED) within the borough, with presentations to the Psychiatric Liaison Service (PLS) from its residents predominantly split between King George’s Hospital (KGH) in Ilford and Queen’s Hospital (QH) in Romford. Barking and Dagenham has the fewest presentations to EDs across the NELFT footprint, possibly because the residents in the west of the borough access EDs in inner London boroughs due to their greater proximity to hospitals such as Newham.<br/>BAME communities are underrepresented in PLS these presentations compared to the Borough’s general population. This has been reflected through stakeholder engagement, where multiple participants brought up the role of stigma in accessing services. People from minority ethnic groups raised being uncomfortable accessing mental health services, often driven by a fear of what consequences this might bring, such as having child custody removed. Participants advised on how some of this may be alleviated with a particular focus on the location and style of service. The lack of association between ED and Mental Health would make it easier to seek help, and that any new service would benefit from being co-located with an existing community service for the same reason. (North East London NHS Foundation Trust Borough Engagement Key features of a service to support people in a mental health crisis, December 2023)<br/><br/>Key consideration for Barking and Dagenham<br/><br/>• Build on the presence of existing hub infrastructure<br/>• Work to address the stigma around mental health services with VCSE groups, especially amongst communities from black ethnic backgrounds.<br/>• Consider how to mitigate financial barriers of accessing services.<br/>• Consider how to locate the service in a way that can be accessed by the whole borough as current services are concentrated in Barking.<br/><br/>Service Aims<br/><br/>The primary aims of the Barking and Dagenham Mental Health Crisis Prevention are to:<br/>• Provide immediate, non-clinical support for individuals, preventing escalation to statutory services like emergency departments and psychiatric liaison teams.<br/>• Reduce pressure on emergency services by offering a safe, non-medical alternative to hospital-based crisis interventions.<br/>• Address mental health inequalities by providing targeted support to underserved and underrepresented groups in Barking and Dagenham, and address stigma around Mental Health.<br/>• Enhance community resilience by offering practical support and linking individuals to appropriate local services, thereby reducing social isolation and promoting long-term mental wellbeing.<br/>• Collaborate with local VCSEs and statutory services to ensure an integrated care pathway, allowing smooth transitions between community and clinical services where needed.<br/><br/>Strategic Context<br/><br/>This service supports the objectives of the North East London Integrated Care Board (ICB) and aligns with the Barking and Dagenham Adults Mental Health Needs Assessment, which emphasizes mental health as a key priority. The NHS Long-Term Plan and the North East London Joint Forward Plan highlight the importance of non-clinical, community-based crisis services that reduce the pressure on statutory services, emergency departments, and inpatient facilities. The B&D Crisis Prevention will serve as a critical component of Barking and Dagenham’s mental health crisis pathway, complementing existing services.<br/><br/>Budget Available: £250,00 per year<br/>Contract Length: TBC<br/> <br/><br/>5. Service Model<br/>Access and Referral Pathways<br/>• Hours of Operation: Demand of service will be flexible and include weekends/out of hours and Bank Holiday’s this will be monitored closely and dependent on change to local needs and demands. <br/>• Outreach Teams: Users of service unable to travel or leave their home. <br/>• Locations: Will be confirmed with provider following award of contract. Easily accessible by public transport, including those with specialist needs, physical disabilities and sensory needs.<br/><br/>Service Delivery<br/>• Support: The service will provide a safe, non-stigmatising environment for immediate emotional support. The core interventions include:<br/>o Peer Support: Trained individuals with lived experience will offer non-clinical, empathetic support.<br/>o Practical Support: Assistance with housing, financial, and employment-related issues that may be exacerbating the distress.<br/>o Outreach and Culturally Sensitive Support: Proactive outreach to BAME communities and individuals facing deprivation, ensuring communication in culturally appropriate ways through partnerships with local VCSEs.<br/>o Safe and welcoming environment: Developing a non-clinical and relaxing atmosphere for all sensory aspects of the space. This might include a sensory calming smell, colourful walls, comfortable furniture, non-claustrophobic and feeling close to nature.<br/> <br/>6. Staffing<br/>The service will be staffed by a combination of:<br/>• Peer Support Workers from diverse backgrounds, trained in crisis management.<br/>• Volunteers, particularly from local communities, including those with multilingual capabilities to support non-English speakers.<br/><br/>7. Safeguarding and Risk Management<br/>• The service will implement robust safeguarding policies and risk assessment protocols to ensure the safety of staff and users of service.<br/><br/>8. Outcomes<br/><br/>Locally defined outcomes<br/>North East London ICB Joint Forward Plan refresh 24-25 Shared Outcomes are.<br/>• Tackling Health Inequalities <br/>• Prevent early death.<br/>• Improve people’s access to care.<br/>• Improve people’s experience of care.<br/>• Enhance people’s quality of life.<br/>• Reduce admission to acute services, reduce lengths of stay and improve where needed supported housing /residential care.<br/><br/>Value and benefits <br/>• Improving equitable and accessible mental health support<br/>• Improve experience of people experiencing mental health challenges<br/>• Improve experience of carers supporting people with mental health challenges<br/>• Improve the outcomes for people who use the service.<br/>• Ensure people receive the right care by the right service in the right place.<br/><br/>The service specific outcomes are: <br/>The key performance indicators (KPI’s) will be agreed with the provider following confirmation of contract.<br/>• Reduced demand on emergency services, particularly for anxiety and depression-related ED presentations.<br/>• Improved access to mental health services for underrepresented groups, including BAME communities.<br/>• Increased community resilience through empowerment and crisis prevention tools.<br/>• Enhanced collaboration between statutory and VCSE services in Barking and Dagenham.<br/><br/>The service specific outcomes are designed to ensure it achieves a positive impact on the system as well as the quality of life of individuals. Outcome will require tracking of individuals’ use of the health system when the service us set up. All outcomes should enable efficiency cost savings through a reduction in referrals to Acute crisis mental health services and acute and emergency services.<br/><br/>10. Partnerships<br/>• The B&D Crisis Prevention will work in close partnership with local VCSEs, as well as statutory services, to ensure integrated care pathways and effective referrals.<br/>• Outreach programs will be developed with local faith groups, community organisations, and to engage hard-to-reach populations.<br/><br/> Conclusion<br/><br/>The Barking and Dagenham Crisis Prevention offers an essential alternative to statutory mental health services, providing culturally sensitive, community-based interventions to prevent the escalation of mental health crises. By delivering timely, accessible support in a non-clinical setting, the service will improve outcomes for individuals, reduce pressure on emergency services, and strengthen the overall mental health provision in the borough. Lot 1: This specification outlines the development of a Mental Health Crisis Prevention Offer in Barking and Dagenham for a third sector-led service providing non-clinical, community-based mental health support. The service will focus on supporting those experiencing self-defined mental health distress who do not require immediate medical attention. It will offer timely interventions aimed at preventing escalation to statutory services like psychiatric liaison or emergency departments. This initiative aligns with local needs, addressing the unique demographic and socio-economic factors of Barking and Dagenham.<br/><br/>Barking and Dagenham has a population of 214,000, of which only 87% is registered with a GP. 53.9% of the population is from BAME (Black, Asian and Minority Ethnic) communities, including 24% from Black ethnic background and 23% from Asian ethnic backgrounds. It is also the second most deprived of the 32 London boroughs when looking at income levels, as 19.4% of the adult population is income deprived compared to a national average of 12.9% and 83% of LSOAs (Lower Layer Super Output Areas) are in deciles 1-3 of the Indices of Multiple Deprivation. The spread of deprivation in Barking and Dagenham is relatively even, although there are increased rates in around Barking, Dagenham and Becontree. (Joint strategic needs assessment (JSNA) | London Borough of Barking and Dagenham 2022). <br/>Stakeholder engagement commissioned by NELFT in 2023 identified that Barking and Dagenham benefits from 8 existing community hubs split across Barking (4) and Dagenham (4) and has access to the online social prescribing platform Joy Marketplace. There are strong public transport links in and around Barking. Barking and Dagenham does not currently have an Emergency Department (ED) within the borough, with presentations to the Psychiatric Liaison Service (PLS) from its residents predominantly split between King George’s Hospital (KGH) in Ilford and Queen’s Hospital (QH) in Romford. Barking and Dagenham has the fewest presentations to EDs across the NELFT footprint, possibly because the residents in the west of the borough access EDs in inner London boroughs due to their greater proximity to hospitals such as Newham.<br/>BAME communities are underrepresented in PLS these presentations compared to the Borough’s general population. This has been reflected through stakeholder engagement, where multiple participants brought up the role of stigma in accessing services. People from minority ethnic groups raised being uncomfortable accessing mental health services, often driven by a fear of what consequences this might bring, such as having child custody removed. Participants advised on how some of this may be alleviated with a particular focus on the location and style of service. The lack of association between ED and Mental Health would make it easier to seek help, and that any new service would benefit from being co-located with an existing community service for the same reason. (North East London NHS Foundation Trust Borough Engagement Key features of a service to support people in a mental health crisis, December 2023)<br/><br/>Key consideration for Barking and Dagenham<br/><br/>• Build on the presence of existing hub infrastructure<br/>• Work to address the stigma around mental health services with VCSE groups, especially amongst communities from black ethnic backgrounds.<br/>• Consider how to mitigate financial barriers of accessing services.<br/>• Consider how to locate the service in a way that can be accessed by the whole borough as current services are concentrated in Barking.<br/><br/>Service Aims<br/><br/>The primary aims of the Barking and Dagenham Mental Health Crisis Prevention are to:<br/>• Provide immediate, non-clinical support for individuals, preventing escalation to statutory services like emergency departments and psychiatric liaison teams.<br/>• Reduce pressure on emergency services by offering a safe, non-medical alternative to hospital-based crisis interventions.<br/>• Address mental health inequalities by providing targeted support to underserved and underrepresented groups in Barking and Dagenham, and address stigma around Mental Health.<br/>• Enhance community resilience by offering practical support and linking individuals to appropriate local services, thereby reducing social isolation and promoting long-term mental wellbeing.<br/>• Collaborate with local VCSEs and statutory services to ensure an integrated care pathway, allowing smooth transitions between community and clinical services where needed.<br/><br/>Strategic Context<br/><br/>This service supports the objectives of the North East London Integrated Care Board (ICB) and aligns with the Barking and Dagenham Adults Mental Health Needs Assessment, which emphasizes mental health as a key priority. The NHS Long-Term Plan and the North East London Joint Forward Plan highlight the importance of non-clinical, community-based crisis services that reduce the pressure on statutory services, emergency departments, and inpatient facilities. The B&D Crisis Prevention will serve as a critical component of Barking and Dagenham’s mental health crisis pathway, complementing existing services.<br/><br/>Budget Available: £250,00 per year<br/>Contract Length: TBC<br/> <br/><br/>5. Service Model<br/>Access and Referral Pathways<br/>• Hours of Operation: Demand of service will be flexible and include weekends/out of hours and Bank Holiday’s this will be monitored closely and dependent on change to local needs and demands. <br/>• Outreach Teams: Users of service unable to travel or leave their home. <br/>• Locations: Will be confirmed with provider following award of contract. Easily accessible by public transport, including those with specialist needs, physical disabilities and sensory needs.<br/><br/>Service Delivery<br/>• Support: The service will provide a safe, non-stigmatising environment for immediate emotional support. The core interventions include:<br/>o Peer Support: Trained individuals with lived experience will offer non-clinical, empathetic support.<br/>o Practical Support: Assistance with housing, financial, and employment-related issues that may be exacerbating the distress.<br/>o Outreach and Culturally Sensitive Support: Proactive outreach to BAME communities and individuals facing deprivation, ensuring communication in culturally appropriate ways through partnerships with local VCSEs.<br/>o Safe and welcoming environment: Developing a non-clinical and relaxing atmosphere for all sensory aspects of the space. This might include a sensory calming smell, colourful walls, comfortable furniture, non-claustrophobic and feeling close to nature.<br/> <br/>6. Staffing<br/>The service will be staffed by a combination of:<br/>• Peer Support Workers from diverse backgrounds, trained in crisis management.<br/>• Volunteers, particularly from local communities, including those with multilingual capabilities to support non-English speakers.<br/><br/>7. Safeguarding and Risk Management<br/>• The service will implement robust safeguarding policies and risk assessment protocols to ensure the safety of staff and users of service.<br/><br/>8. Outcomes<br/><br/>Locally defined outcomes<br/>North East London ICB Joint Forward Plan refresh 24-25 Shared Outcomes are.<br/>• Tackling Health Inequalities <br/>• Prevent early death.<br/>• Improve people’s access to care.<br/>• Improve people’s experience of care.<br/>• Enhance people’s quality of life.<br/>• Reduce admission to acute services, reduce lengths of stay and improve where needed supported housing /residential care.<br/><br/>Value and benefits <br/>• Improving equitable and accessible mental health support<br/>• Improve experience of people experiencing mental health challenges<br/>• Improve experience of carers supporting people with mental health challenges<br/>• Improve the outcomes for people who use the service.<br/>• Ensure people receive the right care by the right service in the right place.<br/><br/>The service specific outcomes are: <br/>The key performance indicators (KPI’s) will be agreed with the provider following confirmation of contract.<br/>• Reduced demand on emergency services, particularly for anxiety and depression-related ED presentations.<br/>• Improved access to mental health services for underrepresented groups, including BAME communities.<br/>• Increased community resilience through empowerment and crisis prevention tools.<br/>• Enhanced collaboration between statutory and VCSE services in Barking and Dagenham.<br/><br/>The service specific outcomes are designed to ensure it achieves a positive impact on the system as well as the quality of life of individuals. Outcome will require tracking of individuals’ use of the health system when the service us set up. All outcomes should enable efficiency cost savings through a reduction in referrals to Acute crisis mental health services and acute and emergency services.<br/><br/>10. Partnerships<br/>• The B&D Crisis Prevention will work in close partnership with local VCSEs, as well as statutory services, to ensure integrated care pathways and effective referrals.<br/>• Outreach programs will be developed with local faith groups, community organisations, and to engage hard-to-reach populations.<br/><br/> Conclusion<br/><br/>The Barking and Dagenham Crisis Prevention offers an essential alternative to statutory mental health services, providing culturally sensitive, community-based interventions to prevent the escalation of mental health crises. By delivering timely, accessible support in a non-clinical setting, the service will improve outcomes for individuals, reduce pressure on emergency services, and strengthen the overall mental health provision in the borough.